Wednesday, November 17, 2010

Prescription Abandonment: Opportunities Lost

It’s a shame that industry’s rep is in tatters right now. Pharma should be delivering an important message to American businesspeople, but they likely won’t pay attention – one, because of the messenger, and two, because it would cost them money – initially -- to fix the problem.

We’re talking about prescription abandonment. A new Annals of Internal Medicine study confirms what common sense tells us: people with limited resources will not pay for prescriptions they cannot afford. The study – conducted in tandem with CVS Caremark over the summer – shows that if a co-pay hits the $40 and above range, people are more apt to forgo the drug, especially if it’s a new script.

An accompanying editorial  also notes the obvious: Someone who doesn’t fill a prescription undermines his treatment, faces increased healthcare costs down the road as well as potentially life-threatening results.

That someone also affects the workplace – in terms of days off, reduced productivity, and so on.

The Annals study isn’t the first. A WSJ blog, citing a Wolters Kluwer study, notes that nearly 10% of new scripts for brand-name drugs weren’t filled in the 2nd quarter of 2010 – an 88% hike over the same time period in 2006.  Comments to this WSJ blog were Scrooge-like. “The bottom line is that people are too unaware of what the actual costs are for health care,” wrote one. “If you don’t think your health is important enough to spend any of your own money [even when insurance is available to you], why should the taxpayers, your employer, or anyone else think it’s important?” wrote another.

Let’s look at a map. Folks at Kaiser Permanente figured out how many prescription drugs people take in the U.S. In two words, it’s stunning. In Tennessee, people between 19 and 64 take an average of 16 medications; in North Dakota, it’s 13, in California, less than 9. We argue that this map shows that people will fill their prescriptions – when they can.

But if big employers do what they’re threatening – shift more healthcare costs to workers – what will happen to those employees at the bottom of the payroll?

A little forethought is needed here. Think about those diseases that are relatively symptomless at first, like type 2 diabetes. Regular doctor’s visits and blood draws would show creeping A1C levels. Diabetes under control is cheaper than diabetes out of control.

Are employers and government agencies being penny wise, pound foolish? We’d say so! We’d also urge industry marketers -- despite pharma's current reputation -- to use these data to help solve the problems and focus on medication adherence solutions that work!

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